title: A comparative study of 3 surgical methods for hysterectomy with staging for endometrial cancer: robotic assistance, laparoscopy, laparotomy.
abstract: OBJECTIVE
  The purpose of this study was to compare outcomes in women who underwent endometrial cancer staging by different surgical techniques.
  
  
  METHODS
  Three hundred twenty-two women underwent endometrial cancer staging: 138 by laparotomy (TAH); 81 by laparoscopy (TLH) and 103 by robotic technique (TRH).
  
  
  RESULTS
  The TRH cohort had a higher body mass index than the TLH cohort (P = .0008). Lymph node yield was highest for TRH (P < .0001); hospital stay (P < .0001) and estimated blood loss (P < .0001) were lowest for this cohort. Operative time was longest for TLH (213.4 minutes) followed by TRH (191.2 minutes) and TAH (146.5 minutes; P < .0001. Postoperative complication rates were lower for TRH, compared with TAH (5.9% vs 29.7%; P < .0001). Conversion rates for the robotic and laparoscopic groups were similar.
  
  
  CONCLUSIONS
  TRH with staging is feasible and preferable over TAH and may be preferable over TLH in women with endometrial cancer. Further study is necessary to determine long-term oncologic outcomes.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27599, USA. jboggess@med.unc.edu
authors.forename: John F
authors.initials: JF
authors.lastname: Boggess
authors.forename: Paola A
authors.initials: PA
authors.lastname: Gehrig
authors.forename: Leigh
authors.initials: L
authors.lastname: Cantrell
authors.forename: Aaron
authors.initials: A
authors.lastname: Shafer
authors.forename: Mildred
authors.initials: M
authors.lastname: Ridgway
authors.forename: Elizabeth N
authors.initials: EN
authors.lastname: Skinner
authors.forename: Wesley C
authors.initials: WC
authors.lastname: Fowler
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D010535:Laparoscopy; D007813:Laparotomy; D007902:Length of Stay; D008197:Lymph Node Excision; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D010052:Ovariectomy; D012371:Robotics; D016896:Treatment Outcome